Longitudinal Changes in Arterial Stiffness and Heart Rate Variability in Youth-Onset Type 1 Versus Type 2 Diabetes: The SEARCH for Diabetes in Youth Study

OBJECTIVE We compared arterial stiffness and heart rate variability (HRV) over time by diabetes type and determined the risk factors associated with worsening arterial stiffness and HRV in young adults with youth-onset diabetes. RESEARCH DESIGN AND METHODS Arterial stiffness (pulse wave velocity, augmentation index) and six indices of heart rate variability were measured twice, 4.5 years apart, among participants with either youth-onset type 1 or type 2 diabetes in the SEARCH for Diabetes in Youth study. Multivariable linear regression models were used to assess risk factors associated with arterial stiffness and HRV at follow-up. RESULTS Of 1,159 participants studied, 949 had type 1 diabetes (mean age 17.1 +/- 4.7 years, 60.3% non-Hispanic White, 55% female) and 210 had type 2 diabetes (mean age 22.1 +/- 3.5 years, 23.8% non-Hispanic White, 71% female) at initial assessment when diabetes duration was 7.9 years (both groups). Participants with type 2 versus type 1 diabetes had greater arterial stiffness and more abnormalities in HRV at initial and follow-up assessment and a greater change over time (all P < 0.05). Risk factors associated with worse arterial stiffness and HRV at follow-up in both types of diabetes included higher blood pressure, hemoglobin A(1c), waist circumference, and triglycerides over time and longer diabetes duration. CONCLUSIONS Arterial stiffness and HRV worsened over time with greater changes among participants with type 2 versus type 1 diabetes and among those with features of the metabolic syndrome. The risk factor profile documents potentially modifiable pathways to prevent or limit cardiovascular complications in young adults with youth-onset diabetes.

Automated summary

This study compared the changes in arterial stiffness and heart rate variability (HRV) among different types of diabetes and identified the risk factors associated with the worsening of arterial stiffness and HRV. The results showed that participants with type 2 diabetes had greater arterial stiffness and more abnormalities in HRV compared to those with type 1 diabetes, and these differences worsened over time. Risk factors for the worsening of arterial stiffness and HRV in both types of diabetes included higher blood pressure, hemoglobin A(1c), waist circumference, triglycerides, and longer duration of diabetes.